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Health Services, Certified Professional Coder (CPC)
CVS HealthCoordinate Medicare compliance with clinical programs as a Certified Professional Coder at CVS Health. Engage with various teams for quality and payment accuracy in health services.
Posted 7/13/2026full-timeRemote • Virginia, West Virginia • 🇺🇸 United StatesMid-LevelSenior💰 $54,300 - $119,340 per yearWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Medicare compliance, including knowledge of CMS Medicare NCD/LCD and proficiency in ClaimsXten. Strong ability to manage claims processing, project deliverables, and collaborate across functional areas to enhance clinical programs.
Highest-signal resume keywords
Certified Professional Coder (CPC)Claims ProcessingMedicare ComplianceClaimsXten ProficiencyManaged Care Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ProcessingClaim EditingProject ManagementClinical Program EnhancementMedicare Compliance
Soft Skills
CollaborationCommunicationProblem-Solving
Tools & Technologies
ClaimsXten
Certifications & Qualifications
Certified Professional Coder (CPC)
Industry Keywords
Medicare Rules and RegulationsCompliance Program GuidelinesCMS Medicare NCD/LCDManaged CareHealthcare Experience
About the role
Key responsibilities & impact- Coordinate the identification of potential claim editing & clinical program enhancements for Medicare compliance
- Collaborate and partner with functional leads and other business areas
- Provide support and management of savings opportunities and provider/customer deviation implementation
Requirements
What you’ll need- Certified Professional Coder (CPC)
- 3+ years processing and/or researching claims for appropriate claim editing
- 3+ years experience in successfully meeting project deliverables
- 5+ years in Managed Care/Healthcare experience
- Compliance Program Guidelines including CMS Medicare NCD/LCD
- Medicare Rules and Regulations experience
- Proficiency in ClaimsXten
- High school Diploma Required - Bachelors Preferred
Benefits
Comp & perks- Medical, dental, and vision coverage
- Paid time off
- Retirement savings options
- Wellness programs